胆总管切开取石探查后一期缝合的研究  

Study on the application of primary suture after choledochotomy for stone removal and exploration

作　　者：何庆良[1] 石铮[1] 陈有挺[1] 翁山耕[1] 林永堃[1] 

机构地区：[1]福建医科大学附属第一医院普外科,福建福州350005

出　　处：《中国现代医学杂志》2006年第22期3460-3461,共2页China Journal of Modern Medicine

摘　　要：目的探讨胆总管切开术一期缝合的可行性及治疗效果。方法选择性对69例术前经过B超、CT或ERCP等检查,并且术中经过胆道镜探查,检查明确无肝内胆管结石,胆总管\肝总管无残留结石,胆道镜能顺利通过Oddis括约肌;胆总管内径大于或等于10mm,胆汁清,胆管壁炎症轻的胆总管结石等患者行胆总管一期缝合。结果69例中术后发生胆漏3例,经引流等对症处理后治愈,术后住院3～14d,平均6.5d。结论在胆总管切开取石探查,术中选择性应用胆总管一期缝合,可缩短住院时间,但对于腹腔镜下胆总管切开,经胆道镜检查,胆总管一期缝合可取得良好效果,患者的痛苦轻,体现微创外科的特点。[Objectives] To explore the feasibility and efficacy of primary suture after choledoehotomy for stone removal and exploration. [Methods] Sixty - nine eases of eholedoeholith were chosen for primary suture after eholedoeholithotomy. The selective criteria were： no intrahepatic biliary calculi by preoperative CT, B-ultrasonography （B-US） and intraoperative B-US or eholedoehoseopy; no residual eholedoehohth; Choledoehoseope and eholedoehal sound larger than F10 could pass Odd＇s sphincter; slight inflammation on the wall of common bile duet （inner diameter〉10 mm） with clear bile secretion. [Results] Among 69 patients, there were 3 eases of bile leakage. All of them recovered after conservative treatment. [Conclusion] Selective primary suture after eholedoeholithotomy may shorten the duration of hospital stay and relieve pain of the patients. Laparoseopie common bile duet exploration with primary closure of bileduct is a safe and feasible minimally invasive operation, While it has a great advantage of minimally invasive surgery.

关 键 词：胆总管结石 微创 腹腔镜 胆道镜 

分 类 号：R657.42[医药卫生—外科学]